In a new mental health documentary series with Oprah Winfrey, Prince Harry is seen undergoing a form of therapy known as EMDR (eye movement desensitisation and reprocessing) to treat unresolved anxiety stemming from the death of his mother, Diana, Princess of Wales, when he was 12.
EMDR was developed in the 1980s by a US psychologist, Francine Shapiro. While walking in a park, Shapiro suspected that her eye movements were lessening the distress of her own traumatic memories. She tested the approach on others and over time built up a standardised psychological therapy for treating people with traumatic memories.
The therapy is recommended by Nice, the National Institute for Health and Care Excellence, and the World Health Organization for post-traumatic stress disorder (PTSD), and it is used for a variety of problems brought on by past trauma. Many patients will have a deeply disturbing event in their past that resurfaces through intrusive thoughts, nightmares or flashbacks, causing fear, anxiety and sometimes an urge to avoid situations that trigger the memory.
People who have EMDR therapy take part in several sessions during which they are asked to focus on the experiences that trouble them and the sensations they cause. In his sessions with the psychotherapist Sanja Oakley, Harry describes flying into London as being a “trigger” for his own anxieties and sense of feeling “hunted”.
While focused on a particular experience or event, people undergoing EMDR receive what is called “bilateral stimulation”. This often means following the therapist’s finger as it moves left and right, or playing sounds into one ear and then the other. In Harry’s case, he crossed his arms and tapped his chest alternately on the left and right side to provide the stimulation. There is no hypnosis involved: people are fully conscious during the therapy.
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The aim of EMDR is to reduce the distressing emotions that particular memories and triggering situations bring on. How it works is unclear, but the thinking is that traumatic events are not stored in the same way as normal, healthy memories, and so they can resurface and intrude. In EMDR therapy, people are forced to divide their attention, focusing on the bilateral stimulation at the same time as they are concentrating on the traumatic event. The therapy doesn’t help people to forget bad memories, but it is said to dampen down the distress they cause by allowing the brain to process and store the memory normally.
The evidence that EMDR works is not overwhelming. A review of studies by the Cochrane collaboration in 2013 found “continued support” for the therapy, but noted that the quality of evidence was “very low”. Last year researchers in the Netherlands performed their own review and found that while EMDR “may be effective” for PTSD in the short term, the quality of studies was too poor to be sure.